tbuckley/cabot-search huggingface dataset:
Association between hospital surgical case volume and postoperative mortality in patients undergoing gastrectomy for gastric cancer: a systematic review and meta-analysis
Authors: Fei-Long Ning, Wan-Jie Gu, Zhe-Ming Zhao, Wan-Ying Du, Min Sun, Shi-Yi Cao, Yong-Ji Zeng, Masanobu Abe, Chun-Dong Zhang
Journal: International Journal of Surgery (2023)

Background: Postoperative mortality is an important indicator for evaluating surgical safety. Postoperative mortality is influenced by hospital volume; however, this association is not fully understood. This study aimed to investigate the volume–outcome association between the hospital surgical case volume for gastrectomies per year (hospital volume) and the risk of postoperative mortality in patients undergoing a gastrectomy for gastric cancer. Methods: Studies assessing the association between hospital volume and the postoperative mortality in patients who underwent gastrectomy for gastric cancer were searched for eligibility. Odds ratios were pooled for the highest versus lowest categories of hospital volume using a random-effects model. The volume–outcome association between hospital volume and the risk of postoperative mortality was analyzed. The study protocol was registered with Prospective Register of Systematic Reviews (PROSPERO). Results: Thirty studies including 586 993 participants were included. The risk of postgastrectomy mortality in patients with gastric cancer was 35% lower in hospitals with higher surgical case volumes than in their lower-volume counterparts (odds ratio: 0.65; 95% CI: 0.56–0.76; P &lt;0.001). This relationship was consistent and robust in most subgroup analyses. Volume–outcome analysis found that the postgastrectomy mortality rate remained stable or was reduced after the hospital volume reached a plateau of 100 gastrectomy cases per year. Conclusions: The current findings suggest that a higher-volume hospital can reduce the risk of postgastrectomy mortality in patients with gastric cancer, and that greater than or equal to 100 gastrectomies for gastric cancer per year may be defined as a high hospital surgical case volume.
Human IAPP is a contributor to painful diabetic peripheral neuropathy
Authors: Mohammed M.H. Albariqi, Sabine Versteeg, Elisabeth M. Brakkee, J. Henk Coert, Barend O.W. Elenbaas, Judith Prado, C. Erik Hack, Jo W.M. Höppener, Niels Eijkelkamp
Journal: Journal of Clinical Investigation (2023)

Peripheral neuropathy is a frequent complication of type 2 diabetes mellitus (T2DM). We investigated whether human islet amyloid polypeptide (hIAPP), which forms pathogenic aggregates that damage pancreatic islet β cells in T2DM, is involved in T2DM-associated peripheral neuropathy. In vitro, hIAPP incubation with sensory neurons reduced neurite outgrowth and increased levels of mitochondrial reactive oxygen species. hIAPP-transgenic mice, which have elevated plasma hIAPP levels without hyperglycemia, developed peripheral neuropathy as evidenced by pain-associated behavior and reduced intraepidermal nerve fiber (IENF) density. Similarly, hIAPP Ob/Ob mice, which have hyperglycemia in combination with elevated plasma hIAPP levels, had signs of neuropathy, although more aggravated. In wild-type mice, intraplantar and intravenous hIAPP injections induced long-lasting allodynia and decreased IENF density. Non-aggregating murine IAPP, mutated hIAPP (pramlintide), or hIAPP with pharmacologically inhibited aggregation did not induce these effects. T2DM patients had reduced IENF density and more hIAPP oligomers in the skin compared with non-T2DM controls. Thus, we provide evidence that hIAPP aggregation is neurotoxic and mediates peripheral neuropathy in mice. The increased abundance of hIAPP aggregates in the skin of T2DM patients supports the notion that hIAPP is a potential contributor to T2DM neuropathy in humans.
Perioperative ctDNA-Based MRD Detection in NSCLC—Response
Authors: Liang Xia, Ying Yang, Weizhi Chen, Lunxu Liu
Journal: Clinical Cancer Research (2023)

We appreciate Yu and colleagues for their interest in our study and we would like to give our reply to their concerns.In LUNGCA-1 study, a total of 330 patients with resected tumor tissues and preoperative blood samples available were included in prognostic analysis, and all but one of these 330 patients had at least one available plasma sample at postoperative 3 days and/or 1 month (1). Thus, preoperative circulating tumor DNA (ctDNA) and postoperative ctDNA-based molecular residual disease (MRD) analysis was done for 330 and 329 patients respectively, as reflected in the number of patients in both Fig. 1 and detailed sample information listed in Supplementary Table S5. LUNGCA-1 study was aimed at evaluating the potential of ctDNA-based MRD during perioperative period for predicting disease relapse and identifying patients who may potentially benefit from adjuvant therapy, and throughout the entire article, there was no mentioning of ctDNA testing after adjuvant therapy.We designed two postoperative blood collection timepoints for ctDNA-based MRD detection. We found that the amount of cell-free DNA increased significantly at 3 days after surgery, and then dropped at postoperative 1 month. ctDNA status at postoperative 3 days was significantly associated with recurrence-free survival (P < 0.001), although with lower prognostic value than ctDNA status at postoperative 1 month (HR: 8.6 vs. 14.3). Among 5 patients whose ctDNA was positive at postoperative 3 days but negative at the other two perioperative timepoints, 4 (80.0%) experienced disease relapse, and the only one who remained disease free had received adjuvant therapy and had a relatively short follow-up (437 days) at the time of data lockdown. Therefore, ctDNA at 3 days after surgery proved to be useful in complementing MRD analysis at postoperative 1 month by increasing detection sensitivity without sacrificing specificity.The current LUNGCA-1 study focused on the association of postoperative MRD detection with disease relapse. The clinical relevance of preoperative ctDNA concentration was not a concern of the published paper and therefore not reported. The criteria for determining ctDNA status had been clearly described in the paragraph "Next-generation sequencing and ctDNA analysis" of the Materials and Methods section, as well as the Supplementary Methods. Disease relapse included locoregional recurrence and distant metastases after surgery, which was determined by radiological methods and/or biopsy.See the original Letter to the Editor, p. 1155W. Chen reports other support from Genecast outside the submitted work. No disclosures were reported by the other authors.
Effectiveness of artificial intelligence-assisted colonoscopy in early diagnosis of colorectal cancer: a systematic review
Authors: Aashna Mehta, Harendra Kumar, Katia Yazji, Andrew A. Wireko, Jai Sivanandan Nagarajan, Bikona Ghosh, Ahmad Nahas, Luis Morales Ojeda, Ayush Anand, Medha Sharath, Helen Huang, Tulika Garg, Arda Isik
Journal: International Journal of Surgery (2023)

Introduction: As artificial intelligence (AI)-assisted diagnosis gained immense popularity, it is imperative to consider its utility and efficiency in the early diagnosis of colorectal cancer (CRC), responsible for over 1.8 million cases and 881 000 deaths globally, as reported in 2018. Improved adenoma detection rate, as well as better characterizations of polyps, are significant advantages of AI-assisted colonoscopy (AIC). This systematic review (SR) investigates the effectiveness of AIC in the early diagnosis of CRC as compared to conventional colonoscopy. Materials and Methods: Electronic databases such as PubMed/Medline, SCOPUS, and Web of Science were reviewed for original studies (randomized controlled trials, observational studies), SRs, and meta-analysis between 2017 and 2022 utilizing Medical Subject Headings terminology in a broad search strategy. All searches were performed and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology and were conducted from November 2022. A data extraction form based on the Cochrane Consumers and Communication Review group’s extraction template for quality assessment and evidence synthesis was used for data extraction. All included studies considered for bias and ethical criteria and provided valuable evidence to answer the research question. Results: The database search identified 218 studies, including 87 from PubMed, 60 from SCOPUS, and 71 from Web of Science databases. The retrieved studies from the databases were imported to Rayyan software and a duplicate article check was performed, all duplicate articles were removed after careful evaluation of the data. The abstract and full-text screening was performed in accordance with the following eligibility criteria: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for observational studies; Preferred Reporting Items for Systematic Reviews and Meta-Analysis for review articles, ENTREQ for narrative studies; and modified JADAD for randomized controlled trials. This yielded 15 studies that met the requirements for this SR and were finally included in the review. Conclusion: AIC is a safe, highly effective screening tool that can increase the detection rate of adenomas, and polyps resulting in an early diagnosis of CRC in adults when compared to conventional colonoscopy. The results of this SR prompt further large-scale research to investigate the effectiveness in accordance with sex, race, and socioeconomic status, as well as its influence on prognosis and survival rate.
Spinal Cord Burst Stimulation vs Placebo Stimulation for Patients With Chronic Radicular Pain After Lumbar Spine Surgery
Authors: Laxmaiah Manchikanti, Mahendra Sanapati, Joshua Hirsch
Journal: JAMA (2023)

To the Editor We believe that there are multiple issues that limit the generalizability of the recent randomized clinical trial of spinal cord burst stimulation vs placebo stimulation in patients with chronic radicular pain after lumbar spine surgery.1
Association of High Normal Body Weight in Youths With Risk of Hypertension
Authors: Corinna Koebnick, Margo A. Sidell, Xia Li, Susan J. Woolford, Beatriz D. Kuizon, Poornima Kunani
Journal: JAMA Network Open (2023)

Importance Ample evidence links obesity to hypertension in youths. However, the association of high normal body mass index (BMI) with obesity and the interaction with different weight trajectories are not well understood. Objective To examine the hypertension risk associated with high normal BMI for age and different weight trajectories in youths. Design, Setting, and Participants This retrospective cohort study assessed 801 019 youths aged 3 to 17 years in an integrated health care system in Southern California from January 1, 2008, to February 28, 2015, with a maximum follow-up of 5 years from January 1, 2008, to February 28, 2020. Data analysis was performed from 2018 to 2022. Exposures Youths were compared by first available (baseline) sex-specific BMI for age and change in the distance to the median BMI for age during the 5-year follow-up. Main Outcomes and Measures Cox proportional hazards regression models with age as a time scale to assess hypertension risk (based on 2017 Blood Pressure Guidelines by the American Academy of Pediatrics from 3 consecutive independent visits), adjusted for sex, race and ethnicity, socioeconomic status, baseline year, and birth year. Results A total of 801 019 youths (mean [SD] age, 9.4 [4.6] years; 409 167 [51.1%] female]; 59 399 [7.4%] Asian and Pacific Islanders, 65 712 [8.2%] Black, and 427 492 [53.4%] Hispanic) were studied. Compared with youths with a baseline BMI for age in the 40th to 59th percentiles, the adjusted hazard ratio (aHR) for hypertension within a maximum of 5 years was 1.26 (95% CI, 1.20-1.33) for youths between the 60th and 84th percentiles if they maintained their BMI for age. With every 1-unit annual increase in the distance to the median BMI for age, the aHR increased by 1.04 (95% CI, 1.04-1.05). The aHR was 4.94 (95% CI, 4.72-5.18) in youths with a baseline BMI for age in the 97th percentile or higher who maintained their body weight. Weight gain increased the risk associated with baseline BMI for age in the 97th percentile or higher with an aHR of 1.04 (95% CI, 1.04-1.05) per 1-unit annual increase in the distance to the median BMI for age. The risk associated with weight change was higher in youths living with low to high normal weight and overweight than in youths living with severe obesity. Conclusions and Relevance In this cohort study of youths, high normal body weight above the 60th percentile of BMI for age was associated with increased risk of hypertension. Weight gain was associated with further increases in hypertension risk. Further research is needed to evaluate the wide range of body weight considered normal in youths and the health risks associated with high normal weight.
Breaking down barriers in medical education: addressing racism and discrimination
Authors: Olivier Uwishema
Journal: International Journal of Surgery (2023)

Oli Health Magazine Organization (OHMO), Research and Education, Kigali, Rwanda Ethical Approval and Consent to participate: Not Applicable. Financial support: None. Competing interests: None Availability of supporting data: No new data generated. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Olivier Uwishema1, Oli Health Magazine Organization (OHMO), Research and Education, Kigali, Rwanda. Tel: +905451545340. E-mail addess: [email protected] (O. Uwishema). This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/
Perioperative ctDNA-Based MRD Detection in NSCLC—Letter
Authors: Mengxue Yu, Lingao Ju, Xinyue Cao
Journal: Clinical Cancer Research (2023)

We read with great interest the article by Xia and colleagues reporting circulating tumor DNA (ctDNA) as biomarker for early detection of molecular residual disease (MRD) and predictor for relapse after surgery in patients with non–small cell lung cancer in a prospective multicenter cohort named LUNGCA-1 (1).LUNGCA-1 was designed to predict prognosis by perioperative ctDNA detection, including preoperative, 3 days postoperative and 1 month postoperative ctDNA. The number of patients in prognosis analysis is 330 (Fig. 1), whereas Supplementary Table S5 shows only 329 patients with at least one postoperative ctDNA sample. In LUNGCA-1, some patients tested postoperative ctDNA before or without adjuvant therapies, while others tested postoperative ctDNA after adjuvant therapies. We questioned the trial design because the authors mixed different aims: MRD detection at a specific postoperative timepoint for recurrence prediction; MRD detection at both preadjuvant/postadjuvant therapies timepoints for evaluation of the outcome of adjuvant therapies. The authors could separate different aims into different trials or do statistics separately in preadjuvant/postadjuvant groups.The authors defined "MRD positive" for patients with detectable ctDNA at 3 days and/or 1 month postoperatively. We noticed that 5 of 26 patients with MRD positive (19.2%) had ctDNA positive only in the detection at postoperative 3 days and their ctDNA detection was negative before and 1 month after surgery. Therefore, we consider the issue of timepoint setting for postoperative blood collection. Diehl and colleagues reported that ctDNA increased after surgery, most likely due to release of ctDNA from damaged tissue (2). Thus, it may be more reasonable to collect blood at a later timepoint after surgery from 10 days to 16 weeks (3). As reported by Chaudhuri and colleagues (4) and Moding and colleagues (5), blood sample should be collected within 4 months for ctDNA detection after surgery or completing radiation and chemotherapy. In this article, the cell-free DNA concentration at 3 days after surgery is also significantly higher than before and 1 month after surgery (Supplementary Table S1), suggesting a more reasonable manner to collect blood for a longer period after surgery. Also, whether the 5 patients with ctDNA positive for only 3 days after surgery relapsed or not was not mentioned.Chaudhuri and colleagues (4) reported that concentration of ctDNA should be correlated with stage and tumor volume, which the authors did not mention. Furthermore, how to determine ctDNA status is positive or negative needs to be clarified. In addition, the criteria for judging the patient's disease relapse were not mentioned in the text or Supplementary Materials and Methods.See the Response, p. 1156No disclosures were disclosed.We thank the grant from the Fundamental Research Funds for the Central Universities in China (4206-413100049).
The current trends in the health burden of primary liver cancer across the globe
Authors: Peter Konyn, Aijaz Ahmed, Donghee Kim
Journal: Clinical and Molecular Hepatology (2023)

See the Original "Global burden of primary liver cancer and its association with underlying aetiologies, sociodemographic status, and sex differences from 1990–2019: A DALY-based analysis of the Global Burden of Disease 2019 study" on page 433.
Impact of the COVID pandemic on major abdominal cancer resections in Germany: a retrospective population-based cohort study
Authors: Konstantin L. Uttinger, Johannes Diers, Philip Baum, Mohammed Hankir, Christoph-Thomas Germer, Armin Wiegering
Journal: International Journal of Surgery (2023)

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is estimated to have claimed more than 6 million lives globally since it started in 2019. Germany was exposed to two waves of coronavirus disease 2019 in 2020, one starting in April and the other in October. To ensure sufficient capacity for coronavirus disease 2019 patients in intensive care units, elective medical procedures were postponed. The fraction of major abdominal cancer resections affected by these measures remains unknown, and the most affected patient cohort has yet to be identified. Methods: This is a register-based, retrospective, nationwide cohort study of anonymized ‘diagnosis-related group’ billing data provided by the Federal Statistical Office in Germany. Cases were identified using diagnostic and procedural codes for major cancer resections. Population-adjusted cancer resection rates as the primary endpoint were compared at baseline (2012–2019) to those in 2020. Results: A change in resection rates for all analyzed entities (esophageal, gastric, liver, pancreatic, colon, rectum, and lung cancer) was observed from baseline to 2020. Total monthly oncological resections dropped by 7.4% (8.7% normalized to the annual German population, P =0.011). Changes ranged from +3.7% for pancreatic resections ( P =0.277) to −19.4% for rectal resections ( P &lt;0.001). Reductions were higher during lockdown periods. During the first lockdown period (April–June), the overall drop was 14.3% (8.58 per 100 000 vs. 7.35 per 100 000, P &lt;0.001). There was no catch-up effect during the summer months except for pancreatic cancer resections. In the second lockdown period, there was an overall drop of 17.3%. In subgroup analyses, the elderly were most affected by the reduction in resection rates. There was a significant negative correlation between regional SARS-CoV-2 incidences and resections rates. This correlation was strongest for rectal cancer resections (Spearman’s r : −0.425, P &lt;0.001). Conclusions: The pandemic lockdowns had a major impact on the oncological surgical caseload in Germany in 2020. The elderly were most affected by the reduction. There was a clear correlation between SARS-CoV-2 incidences regionally and the reduction of surgical resection rates. In future pandemic circumstances, oncological surgery has to be prioritized with an extra focus on the most vulnerable patients.
New Insights into the Evolution and Gene Structure of the Mitochondrial Carrier Family Unveiled by Analyzing the Frequent and Conserved Intron Positions
Authors: Magnus Monné, Antonia Cianciulli, Maria A Panaro, Rosa Calvello, Anna De Grassi, Luigi Palmieri, Vincenzo Mitolo, Ferdinando Palmieri
Journal: Molecular Biology and Evolution (2023)

Mitochondrial carriers (MCs) belong to a eukaryotic protein family of transporters that in higher organisms is called the solute carrier family 25 (SLC25). All MCs have characteristic triplicated sequence repeats forming a 3-fold symmetrical structure of a six-transmembrane α-helix bundle with a centrally located substrate-binding site. Biochemical characterization has shown that MCs altogether transport a wide variety of substrates but can be divided into subfamilies, each transporting a few specific substrates. We have investigated the intron positions in the human MC genes and their orthologs of highly diversified organisms. The results demonstrate that several intron positions are present in numerous MC sequences at the same specific points, of which some are 3-fold symmetry related. Many of these frequent intron positions are also conserved in subfamilies or in groups of subfamilies transporting similar substrates. The analyses of the frequent and conserved intron positions in MCs suggest phylogenetic relationships not only between close but also distant homologs as well as a possible involvement of the intron positions in the evolution of the substrate specificity diversification of the MC family members.